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World J Gastroenterol. May 14, 2008; 14(18): 2838-2843
Published online May 14, 2008. doi: 10.3748/wjg.14.2838
Is a 7-day Helicobater pylori treatment enough for eradication and inactivation of gastric inflammatory activity?
Carlos Robles-Jara, Carlos Robles-Medranda, Manuel Moncayo, Byron Landivar, Johnny Parrales
Carlos Robles-Jara, Carlos Robles-Medranda, Gastroenterology Division, Instituto Ecuatoriano de Enfermedades Digestivas y Pélvicas (IECED), Portoviejo 1301266, Ecuador
Carlos Robles-Medranda, Gastroenterology Division, Hôpital Edouard Herriot, Lyon 69003, France
Manuel Moncayo, Gastroenterology Division, Instituto Ecuatoriano del Seguro Social, Portoviejo 1301266, Ecuador
Byron Landivar, Epidemiology Division, Hospital Oncológico Julio Villacreses Colmont, Sociedad de Lucha contra el Cancer (SOLCA) or Registro Nacional de Tumores, Portoviejo 1301266, Ecuador
Johnny Parrales, Laboratorio de Histopatologia (LABOPAT), Portoviejo 1301266, Ecuador
Author contributions: Robles-Jara C and Robles-Medranda C designed research; Robles-Jara C, Moncayo M and Parrales J performed research; Robles-Medranda C and Landivar B analyzed data; Robles-Medranda C and Robles-Jara C wrote the paper.
Correspondence to: Carlos Robles-Jara, MD, Instituto Ecuatoriano de Enfermedades Digestivas y Pélvicas (IECED), Hospital Clinica San Antonio. Av. Paulo Emilio Macias y Tenis club, Portoviejo 1301266, Ecuador. carlosroblesj@hotmail.com
Telephone: +593-5-2637672
Fax: +593-5-2633265
Received: January 5, 2008
Revised: April 8, 2008
Published online: May 14, 2008
Abstract

AIM: To compare the efficacy of a 7-d vs 10-d triple therapy regarding H pylori eradication, endoscopic findings and histological gastric inflammatory inactivation in the Ecuadorian population.

METHODS: 136 patients with dyspepsia and H pylori infection were randomized in 2 groups (68 per group): group 1, 7-d therapy; group 2, 10-d therapy. Both groups received the same medication and daily dosage: omeprazole 20 mg bid, clarithromycin 500 mg bid and amoxicillin 1 g bid. Endoscopy was performed for histological assessment and H pylori infection status before and 8 wk after treatment.

RESULTS: H pylori was eradicated in 68% of group 1 vs 83.8% of group 2 for the intention-to-treat analysis (ITT) (P = 0.03; OR = 2.48; 95% CI, 1.1-5.8), and 68% in group 1 vs 88% in group 2 for the per-protocol analysis (PP) (P = 0.008; OR = 3.66; 95% CI, 1.4-10). Endoscopic gastric mucosa normalization was observed in 56.9% in group 1 vs 61.2% in group 2 for ITT, with similar results for the PP, the difference being statistically not significant. The rate of inflammatory inactivation was 69% in group 1 vs 88.7% in group 2 for ITT (P = 0.007; OR = 3.00; 95% CI, 1.2-7.5), and 69% in group 1 vs 96% in group 2 for PP (P = 0.0002; OR = 7.25; 95% CI, 2-26).

CONCLUSION: In this Ecuadorian population, the 10-d therapy was more effective than the 7-d therapy for H pylori eradication as well as for gastric mucosa inflammatory inactivation.

Keywords: Helicobater pylori treatment; Helicobater pylori infection; Gastric inflammatory inactivation; Triple therapy eradication; Randomized study